CDC and the Food and Drug Administration (FDA) are now advising that U.S. consumers not eat and retailers and restaurants not serve or sell any romaine lettuce from the Central Coastal growing regions of northern and central California. This updated recommendation comes as CDC, FDA, health officials in several states, and Canada continue to investigate a multistate outbreak of Shiga toxin-producing E. coli O157:H7 illnesses linked to romaine lettuce.

If you do not know where your romaine lettuce is from, do not eat it.

Romaine lettuce will be labeled with location information by region. It may take some time before these labels are available. When the labels are available, check labels or store signs for growing region before buying or eating romaine lettuce.

Romaine lettuce harvested from regions outside of the Central Coastal growing regions of northern and central California is not linked to this E. coli O157:H7outbreak. Romaine lettuce grown in greenhouses or hydroponically is also not linked to this outbreak.

Forty-three people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 12 states. Sixteen of those people have been hospitalized, including one person with hemolytic uremic syndrome (HUS). No deaths have been reported.

Whole genome sequencing (WGS) results from CDC and state health departments showed that the E. coli O157:H7 strain isolated from ill people in this outbreak is closely related genetically to the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada. The current outbreak is not related to a spring 2018 multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce. People in the spring outbreak were infected with E. coli O157:H7 bacteria with a different DNA fingerprint.

CDC continues to work with states to collect information from ill people and test the bacteria making people sick to determine if those people are part of this outbreak. This information may provide clues that FDA can use to trace back the romaine lettuce. FDA and states are working to trace back romaine lettuce that ill people ate in the current outbreak. At this time, no common grower, supplier, distributor, or brand of romaine lettuce has been identified. FDA is working with industry to add labeling to product to enable consumers and retailers to follow this new recommendation.

This investigation is ongoing, and CDC will provide more information as it becomes available.